| NPI | 1679609929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: KY 42491) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: KY 42491) |
| 207R00000X Internal Medicine (Licence: KY 42491) | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2013-03-04 |